S4E6: Included, But Not Investigated: The Missing Pieces in Women’s Health Research

Hello, and welcome to Women's Health Interrupted. I'm your host, Dr. Lisa Glia. Today, we're exploring why women in research matters, because women aren't just a subgroup of humanity, we're literally half of it. Today, I'm speaking with Katie Schubert, president and CEO of the Society for Women's Health Research, a leading voice in advancing research and policy that reflect sex and gender differences across the lifespan. We'll look at the history that shaped women's health research, what's working, what isn't, and what needs to change next to deliver better outcomes? We actually have a correction in this episode. I state that I know myosis affects 80 percent of women. This is incorrect. Actually, we don't really know the correct number, but the figure should be around 20 to 30 percent. That's the best of estimate at this time. Welcome, Katie. Can you tell us what is a society for women's health research? Yeah. What do we do? What do we do, are we? Who are you? I wonder that often. The Society for Women's Health Research is a U.S.-based nonprofit organization that is really rooted in advocating for the inclusion of women in clinical research. We were founded in 1990 to work with the U.S. Congress and get the NIH Revitalization Act passed, which at that point required that women be included in clinical research if it was funded by the NIH. Can you just underscore that again, because people will often use that, like, 1993 clinical trials without that caveat that it's, but it's NIH front, it's not all clinical trials, right? 100 percent. And I often hear two books talking about global sort of the royal we as women not being included in research until 1993 and really what that is referencing is the U.S. legislation that required and the mechanism by which they were able to do that was if it were NIH funded. And so that's really what we worked on when we first started and then we turned to continue to make sure that that was being implemented and that there was representation in research. We also worked with the NIH again to push for the sex as a biological variable policy. So even if you include, as we saw women in clinical trials, that's human research. And we know that there are sex differences down to the cellular level. So we were trying to get to that issue. So that even from the beginning of a research concept, we were looking at these differences. So that was a policy that was implemented at the NIH in 2016. And that still was not, I mean, that was not that long ago, that was a decade ago. And so I think there's, there's a long way we probably still have to go. But our work at the society is really rooted in that policy advocacy. So better inclusion, better access to innovative treatments and therapeutics, a better research and clinical workforce that is equipped and empowered to treat their female patients. A lot of doctors are not, don't necessarily learn about those sex differences in medical school. And so trying to get to that. And then we have a lot of public facing materials. Those look like patient toolkits for specific conditions or diseases or life stages. We might take on clinician fact sheet. So trying to get to those primary care clinicians who maybe don't know about lupus or endometriosis. And so trying to get to those frontline workers who maybe someone would see first so that we can shorten the diagnosis time. And we really work in anything that differently disproportionately or uniquely impacts women, which is everything because we see these differences across the board. Okay. So that was going to be one of my questions. What does women's health mean to you because I think that there is an idea and I love that there was a, I just saw this on your LinkedIn profiles. What counts as women's health? Yeah. The 20 billion dollar question. Yeah. And so that was really intentional. I love it. Listen, 20 billion dollars is huge. It's a huge amount of money and we're calling for it over 10 years. It is a north star for not just the women's health community. But this question of what does that mean when you talk about women's health? The intentionality of pulling together national patient advocacy organizations like the American Heart Association, like the endocrine society, which does sex differences, but they're not a women's health organization specifically. Pulling together us against all simers and the autoimmune association. The National Health Council represents all of the national patient organizations because women's health is all health. It's not just, and we're not, yeah, we're not talking about just sex specific, right? Reproductive health. Yeah. Very important. Very, very important for sure. But this is really meant to be much more comprehensive and really get to that more personalized piece of the health care ecosystem than we have before. I think the other piece of this is in terms of the 20 billion dollar question. We've made incremental change since 1993. We have seen increases in funding. Nobody's denying that. It is not enough, right? Like, and let if you really want to truly fix the system that we are living in, you have to tackle it comprehensively. And our thinking is that if you were to infuse the system with a large amount of funding across a number of different areas, we'll be able to not only close the women's health gap, but we'll also learn so much more about what's happening with men. How can we see why they're not living as long as women? How can we make sure that their mental health is doing better? Things that we know to be true about mental health as well. You know, I often try to make the point that whatever we learn in women's health will help other sexist and genders, including men's health, and I actually had a patient advocacy group because we had a finding on memory and post-menopausal women looking at transdermal esterial versus oral esterial. And I had some prostate cancer survivors reach out to me and say that transdermal esterial actually really improves their quality of life and how could I help them advocate for more transdermal esterial? And I was like, this is really fantastic news. And we are going to be stronger to gather when we advocate for more attention to sex and gender and our histories, our sort of life histories, and how they might be affecting our health. So you said a number of things that I'd like to talk about. So one is, what is this national strike? I should try and find it here, what are you calling it? It's called the national strategy to close the women's health gap. And we are calling on Congress to invest $20 billion with a B dollars in women's health research and care. And there's five buckets we're looking at. We are calling on them to do this over 10 years. So the first bucket is increased research funding. So and it's not just relegated to the NIH, it's any federal research enterprise that conducts biomedical research. So NIH asks that's probably going to be the biggest bucket, although Department of Defense, Veterans Affairs, ARPAH, all of those agencies. We're also looking at regulatory modernization and coordination. So this is trying to get to this idea that, you know, if you're looking at innovative therapies and treatments or, you know, research findings, the structure under which that happens is pretty antiquated. And so we're working through this as an opportunity to think about how can those agencies work better together, whether that's, you know, data standardization or harmonization or the regulatory pathways that you might look at. We have a lot of questions about what are the health outcomes or the end points in research for women and we see that particularly when we look at research into pregnancy, like you have to look at outcomes and end points for both mom and fetus. And so that gets a little bit tricky because again, it wasn't something we were looking up before. And so we want to make sure we get that right. So that's sort of the second piece of this. The third piece is the workforce piece. So making sure that the pipeline of researchers and clinicians is shorn up, you know, obviously right now we're very concerned about young investigators or those folks who are mid-career, not being able to access research dollars or maybe they aren't in women's health or in sex differences. They're in some other area and so we're losing ground there. So this would increase and scale up some of the existing infrastructure surrounding workforce here in the US. We have the birth program and the worker program. So training for researchers and women's health and really thinking about are there other opportunities to incentivize people to really think about how this is a career for them. Is this for scientists or also for healthcare professionals? Both. Or anybody. Yeah. It's for scientists and healthcare professionals. So there is also this piece about, you know, what are we learning in medical school? Or, you know, we have the nurse midwives and nurse practitioners and folks like that as well because that's just as important to. Physiotherapists think like even allied health professionals. Good question. Yeah. I think I think anyone who wanted to be in the women's health space would have access to these programs. All of the medical providers, right? Whatever that looks like allied health professionals, physical therapists, all of them to understand what those differences look like, but also to give them an opportunity to specialize in women's health. We actually are seeing that quite a bit in these areas. So it's really anyone who, as an interest, we're looking at what that infrastructure could look like to support their education, their training and all of that. The fourth bucket is looking at data, and we are calling specifically for a public private partnership to try to leverage existing data from sources that may be the federal agencies would not have access to. Obviously wearable. comes to mind first for most people, but I think there's other opportunities there as well. I think there's also a conversation that obviously needs to be had about how we're standardizing data collection efforts, how we're standardizing definitions of what we mean and making sure that we can, you know, compare data, of course, because if we can't do that, we can't actually make change. The other issue about data is did they collect the data, you know, we know things like whatever, number of pregnancies or whether or not you take them on account of symptoms, right? I think there's a lot of data that isn't being collected or there is quite frankly a hesitancy to give that information sometimes because you don't know how it's going to be used. I think the other piece is on the standardization or the definition side. I remember having a conversation with CEO of a large patient organization about sex versus gender, right? And the conflation of the two, and you know, I sort of have had the conversation that well, those are two separate data points, both very important, but unless we're all on the same page using the same language, you actually can't compare any of this data. So yeah, so I think that will be really important. And then the last month it is related to education and awareness. So more like public health information, getting the word out directly to the population about what these sex differences look like, about when we are looking at sex-specific information, endometriosis, uterine fibroids comes to mind, right? Pretty high prevalence on their uterine fibroid side. Yeah, it still takes, you know, four years to diagnose it. So if we can do a better job of making women aware and really encouraging the conversations, and this is actually probably like a community conversation to be had. I don't think it's just relegated to women specifically, but if you had a general awareness of some of these health issues, you might feel more empowered to be able to bring it to your clinician and have a conversation. So whether that's, you know, across communities, cross-generationally, right? I do a lot of talking about, are we talking with our mothers and our grandmothers and our daughters about our health histories? And so really trying to get to that piece too. Do you know what the prevalence rate is for uterine fibroids? And don't meet you. This is about 10% of women that we know of. I would guess it's probably more. Yeah, yeah. And that length of diagnosis is seven to 11 years. Yeah, yeah. And it's sister or cousin, I know myosis, which some people think is like a precursor, which is what I have, which I think lots of listeners will already know, because I've just cooked that before. But that's up to 80%. Wow, like the estimates are hard to come by. It's hard to know because of, you know, obviously, it's very hard to diagnose these things. Fibroids itself is particularly infuriating only because it is up to 80% of black women and 70% of all women have them. And so that's there. I mean, that's prevalent. Yes. And you're still showing up and, you know, not figuring out what's going on until, you know, years later. So it doesn't make sense, right? No, it doesn't make any sense. And we talk a lot about sex differences, gender differences, but then obviously it's compounded by intersectional variables like ethnicity. And I've learned a lot about black women's health and the fact that they're more likely to have hysterologies because of the propensity for uterine fibroids. And then so what does that have to do to your health later on in life? Yeah. I think they're really, really important questions that we're not paying enough attention to. I totally agree. And you see those disparities across conditions. So it's right. Like I'm just getting more mortality. So strongly, we know in menopause, even, and this is just more of like a more severe symptoms or earlier symptoms. You know, we're just learning more about sort of what those disparities look like, but they, they're so clear. So, just going back to something that you said earlier about the Re-vitalization Act in 1993 about inclusion of more women in clinical trials. And then the SABV, the sexes biological variable for pre-clinical sort of biomedical research. Do you know or do you want to, should we, should we, shall we disclose to our listeners? There's something about inclusion, but then there's another part about reporting and analyzing to see whether or not these variables make a difference. Yeah. And we know it's pretty low, correct? It's a gap. Yeah, it is. And it's something where the, you know, that policy for consideration of sex differences, which is exactly what it sounds like, right? Like you just have to say that you considered that there might be. And then you can easily say, well, I considered it, but I didn't feel that I needed to do anything about it, which is very different than actually, you know, collecting the data and analyzing it, disaggregating it, cross-referencing it, you know, the other piece is really related to correcting for those differences. Yeah. So, this is the other problem. Bananas. It's wild, right? Like, it is. It is. It's wild. Yeah. So, just for the audience. Just for the audience. Yeah, yeah, yeah, explain it. We need to explain it. Do you want me to, do you want me to explain it? Yeah, no, you're the scientist. Yeah. So, what happens is that people will take, might take sex information or gender information, but then it's, and then they'll say that they're analyzing it, but what they're doing is they're, they're, quote, unquote, controlling for it or using it as, often it's used as a covariate. Sometimes they even call it a nuisance variable, which I always find amusing. I know. It's very, so sweet. And so, basically, what that means listener is that they're just taking that variable and they're removing it from what they're looking at. So, they're, they're, they're taking out any kind of variability in the data that might be under the guidance of sex or gender. So, that's not looking at it. That's, that's basically ignoring it, right? It's actually proactively ignoring it, right? It's proactively ignoring it. Which, which is interesting because we had a whole conversation about this in the Alzheimer's disease space. And I knew that this was happening. And it does make sense if you think about why, this has been a problem, right? Like this idea that either women were included or, you know, nobody was really looking at sex differences. Well, it does make sense because if you're conducting an experiment, you want to be able to control for everything you can. 100%. No, that's not reality, right? Like, give me, give me a patient who only has Alzheimer's. That would be a uniform. That doesn't exist. So, so the, the scientific method of, you know, right, removing inducence variable, would, it makes sense if you're thinking that way. I would argue and I think, I think we all probably agree on this that, you know, that's not reality. There are males and females and we could talk about gender and gender identity. Like, there's all these different factors. In addition to their being things like age hormones is the other way. The reason why they weren't looking at females is because it's female mice are difficult when it you think about hormonal cycles. And so, if that's, if you're not looking at that specifically, you want to just avoid it. So, yeah, it's, it's a problem now. My, my standard reaction to that is, you know, male mice and male humans have diurnal fluctuations, daily fluctuations in testosterone levels. So, you know, you're talking about four to five days in a mouse in terms of their estrogens and progesterone levels, but you're talking about daily, every day. It changes and male mice. So, and also depends on their cage partners. But that's also true in humans as well. It's really high in the morning and then it declines about about 50% across the day. So, like, my, my standard joke response is like, who's more hormonal? Somebody that goes to hormonal daily or monthly, like, come on. Yeah. Right. I mean, it's, it's really fascinating. But I think to the point about, you know, consideration versus analysis, that is an area of need right now. It is something that we have been pushing for it alongside many others. And there was actually, this is one thing that NIH has started doing, which is that instead of a checkbox, right, where it's like, I, you know, considered this. Now, there's a narrative. And so, and I will say, we were a little bit weary because we weren't quite sure, like, oh, why is this changed? But it, it, it's, it really actually, I think, is better because it makes you stop and really actually think if you have to explain it versus just checking a box. So, we're watching not carefully, though, just to make sure it's going to do what we think it will do. But it still doesn't require analysis. It still doesn't do, you know, all of the things we would like to see it do. I mean, in Canada, we have the same kind of pressure points, even though it's called, as you probably are aware, it's called SGBA in Canada, so sex and gender-based analysis as opposed to SAPB. But we still have the same kinds of issues. We have a mandatory box where everybody says they're going to do everything, but then in the actual proposal itself, you know, might be relegated to one line. And there are pluses and minuses to both of those approaches. I have, I have thoughts, which we can always get to at some point. But tell me a little bit, so we, I think we didn't get to the fifth point. So you have five pillars, which we might need to, like, say again. Yes. So the five pillars are increased research funding, regulatory modernization and coordination, workforce, data, data standardization, data collection. The fifth one is public health education and awareness. All of these things are so key. So Canada right now has a, it's in front of Parliament, I think they vote in October for a national strategy for women's health. I have heard that Australia has one, that you has one. And this strikes me as something that we should look into your. National strategy to close the women's health gap. Right. And we did look, I mean, we are always learning from other countries and regions to see what we can share or learn. I think this one in particular, again, right now, it's a framework, which we would hope to then turn into legislative specifications so that our legislators can pick up the whole thing or pieces of it and move it forward. But it's also something that we can track against over the next 10 years. I love it. If you care about menopause research or endometriosis, you know, and there's legislation that passes on that or there's funding that goes through on that, we can, you know, check against that total number. Yeah. So I'm going to ask you question is 20 billion enough? Great question. I am referring to it as a down payment. Yes. Because I think it's really like, well, we're so far behind. It's going to take, I mean, I have always said it's going to take billions, not millions, and we've only seen millions. We saw almost a billion of investment in the, from the federal agencies in 2024, like through the end of like over the calendar year 2024. And that was really just scratching the surface. And so some of this really is about the structures that exist and that takes a huge investment upfront to be able to create the odd and obmeetingful way. And then the idea is that we have this down payment, but it builds the structure across the federal agencies and across the government entities. You engage the public sector, private sector, philanthropic center. So you have, this is really looking at that like public sector side. And then you have your funding from Melinda French Gates. And then you have the Gates Foundation. And you have so much interest now on the philanthropic side that will help alongside that. Zuckerberg, too, I think. Yeah, yes. I think so too. I think so. Yeah. And then, you know, we also have corporate investment, which we're looking at to make sure that they're also, I mean, this is a workforce issue, too, so we want to make sure there's investment there. And then this idea of the venture capitalist funds, which we've seen, that's increasing too. Now it's 1% to 2%, but like we're getting there. So this is really meant to be sort of the next piece, like another pillar in a broader strategy. But the reality is the federal government, the U.S. government is the number one funder of biomedical research in the world. And we're never going to be able to either make up for this gap without it. And so, you know, I think we'll be tracking over time to really, to really see, but this is really like, this is what we think we'll get to that sort of phase of creating the infrastructure that's needed to be able to over time get to it. I think the national academy is called for 15 billion just at the NIH. You know, this crosses a number of different areas beyond just the NIH, you know. And so I think we feel good that it's a, it's a good number to start with. Yes. Yeah. I think so. And we're calling it also like an investment in America. This isn't like just about, you know, women's health and, you know, not feeling well. This is about our economic and our competitiveness and really making sure that we're still, you know, where we should be. Yeah. I'm sure you're very well aware of the McKinsey report, right, who that's suggested that if we could achieve gender parity in our health knowledge, that we would save the worldwide economy $1 trillion a year. Yeah. I actually think that's an underestimate in Canada. It's 37 billion. It depends on how people are coming up with that number. But, you know, even with a sheer knowledge that it's 10% of the workforce leaves at menopause. Yeah. Like that's a large percentage of your workforce, right, leaving. Yes. And we found in our last survey, and we have news survey data coming out soon that I can't speak to all those. It's going to be very exciting. And I think it's going to really be pretty groundbreaking in terms of the menopause workforce piece. But we did find in our initial survey that I think it was three out of five women either did leave their job or didn't pursue leadership opportunities due to their symptoms. And I would say like think of that age, right, a midlife woman is at the top of their game. They're probably in your leadership structure or management structure. How much does it cost you as a company to train, retrain somebody and coming in there, right? Yeah. You know, it's just like, and it's not, and I don't want to say anything. It's not, everything's not easy. However, there are things that can be done, we're hoping to support 100%. Exactly. Exactly. Yeah, so I have one of my favorite slides I made was a meme from the, I don't know, meme gif, whatever they called. I'm not young anymore. From the Barbie movie, you know, like it's literally impossible to be a woman. There's a really great monologue at the end. And it's about the average age of menopause, I mean, it changes a little bit. It was about 51.8 years of age. And the average age of leadership is 52.4 or something. So it's almost exactly aligned. So, yeah, I think, and I think a lot of workforce, workplaces are really getting more interested in how they can support their workers, no matter what their sex or gender is, but without being agnostic to, like, actually paying attention to it, which is fantastic to see. Yeah. I totally agree. And we've been challenging employers to review their benefit structures. Yes. The, probably that low hanging fruit is, you probably already have something available that would apply to this population, but maybe your employees don't know that and you, or you don't know how to talk about it. And so rather than siloing, right, like fertility and maternal health and then breast cancer, which are, those are sort of like the three that we are most about, you know, you can pull together sort of what works for that population. Like, why is what, what is it that your male employees are dealing with? I actually have heard of one company out in Michigan who has an ERG, you know, an employee resource group for men specifically, but it's to support their wives and metaphors. And so there's great because they were like, oh, well, all the women who work here are meeting about this, but like, we have, we need to know too, which is so, I mean, right? It's sad that that's groundbreaking, but I think it just says so much about where we are in terms of the information that we have, but we need to be able to be ready to support when people are asking for that assistance. Yes. Yes. I will say that I've done a few metaphors facing events for the public and there are some men in the audience and they disclose that they're there for their wives like they want to support and they want to learn, which is really, really fantastic. So I think investment is one thing which is going to be great, right, if this all goes through and honestly, low hanging fruit and we're going to be able to get back to society so much, but willingness is another. So, you know, sort of that commitment on the part of not just agencies across, because it's a big number of, you know, industry, federal, academic, hospitals, you know, it's quite a medical education, right? It's quite, quite a big envelope you're, you're catching, but, you know, I worry a lot about us being in a bubble of the social media that comes through our Instagrams and our TikToks and whatever, you know, our algorithm is showing us what we want to see. But in your field, you're actually going out and knocking on doors in Congress as well as in other places as well. So do you see a willingness or do you see some shifting in people wanting to, I learn more at least? Yeah. I do. I think here's the thing. We have never once had a number of Congress or a policy maker stay. We are against. Oh, great. Investing in women's health research, right? Like, that's never happened. And I, and I, I have been in some uncomfortable film meetings before where I've been advocating for things that I have heard while we are against this. We have not heard that. The problem is that with everything else coming to, you know, there's so many things. Sure. To their attention. It doesn't rise to the top, which is part of why we launched the national strategy because it really was meant to make this a national public health issue, right? To really give it the, you know, right, like this isn't just women's health. That's why we wanted to go make sure we had support of those non-women's health organizations although I've always been arguing that everybody is a women's health organization. It doesn't matter what you do. Absolutely. I love that. Yeah. Yeah. Like, in the broader context of, you know, we talk about funding a lot. Well, there are so many, you know, interests related to federal funding. And there's also, you know, different ideas that, you know, different political parties have about where funding should be going and what needs to be prioritized. So, yeah. Part of what we do, even beyond the strategy, is, you know, we convene bipartisan stakeholders. And we have conversations where we can learn from one another and, you know, you can have members of the House and the Senate and you can have members of either a political party coming together to just say, okay, well, maybe we don't agree on everything. But, you know, what? Let's try to do something on metapause or let's try to do something in endometriosis. So, heart health is a great example, right? Yeah. Like, very bipartisan. So, I think it, I feel good about it. It's just that, it's, and you talk about the bubble of social media, I also think just like the news cycle, which is not how either because it feels, it all feels very heavy. Yes. But I always feel energized after we're up there and I feel good about the work that we're doing and that it will move forward. It's going to, I mean, it's certainly not going to be easy. I do think like we've seen that increase in funding over. over time and I do, I would expect that that would continue. - Yeah, that's really, really fantastic. I mean, I see you, one of my questions was sort of cheeky, but like I, I see, I, again, it might be my algorithm, but I see the difference that SWHR is making and I see you in particular really putting yourself out there on social media and if I'm including LinkedIn there, which is what I'm including in there, but it's just so important to get out there and keep spreading that message because, you know, you just don't know what's gonna land with, with certain people and finding that commonality so that people can move forward together and say, oh, you know, actually I do see the point of this because it is gonna help everyone from cradle to grave. - I jokingly said, womb to tomb the other day. - Oh yeah, womb to tomb, I like that. - I think I got it. - We sound a little morbid, but I, first of all, thank you for noticing that because it is really, number one, policy and advocacy can be a little bit of a black box or can feel that way. But it's also what has been modeled, you know, I've sort of seen all sides of this. So while I'm not, you know, a trained scientist, I started my career on Capitol Hill. I was on the other side of that table with groups coming in to talk about what they wanted to do. You know, we know how this all works, but I've also then transitioned, you know, I was a lobbyist for a long time working with medical professional societies and patient advocacy organizations and have always believed that working across Isles is really the only way to get things done. Number one, we are nonpartisan. We're a 501(c)(3) organization that's very important. But we're also like, we're gonna come together for what the best policy is. And it doesn't matter who's supporting it, right? Like if you feel like you want to help take this up, we want to work with you because we just want to get it done. - Right. - Right, at the end of the day, I would love for us to be put out of business like so that we don't have to talk about this anymore. - Wouldn't that be amazing? - Amazing. - Yeah. - Sometimes in my bio, it says tireless advocate, and I'm thinking about like taking that tireless part out. - tireless. (laughing) I'm a little tired. - We need to take care of each of ourselves. - We do, we do, we do. And to your point, and I know this is a phrase that gets at a lot, but it is very, very important. That is that we're stronger together. And I really feel that from the tip of my toes, we need all the different voices. I actually appreciated my kids are starting to age out, but I appreciated when my kids were so young and they tell me, "Mommy, sound old." (laughing) Or, you know, like I needed, I needed that. I need that because I think it's really important for us to hear different voices so that we get stronger, our message gets stronger, and precision medicine, personalized medicine, whatever. We're never gonna get there unless we understand what variables need to be considered for our health to be optimal, and not as much as about our health, but everything, everything within our lives, which obviously contributes to our health. - Yeah, I think that's right. And I think to your point about sort of who are we speaking to, what rooms are we in? This has been another big piece of this, which is, we could show up for, you know, years in the same rooms with the same people, which I love, right? I love our people. So fierce in terms of advocates and passionate, but if we're only talking to ourselves in an echo chamber, we're really not going to get anything done. It's not gonna solve problems. So we really are looking at different rooms to be in, different organizations who maybe haven't, they are not, they haven't seen that this should be a priority for them. How can we work with you? What are the conversations that you're having? But I do think like, again, this may be my algorithm, I don't know, but I think there are more people talking about this issue than ever before, and it's promising, right? It's gonna take some time, but like, we have to get out of our own comfort zone too, to be able to make the change that needs to happen. - Yeah, and you know, change happens because we're uncomfortable. Like it, change never happens because we're comfortable. It's, you know, if you're uncomfortable where you're sitting in the chair, you're gonna move the pillow around. I think you are gonna change your position. You are gonna change the pillow, or the TV show, or whatever. And I appreciate when somebody is willing to listen, and that goes for me too. I need to be willing to listen to a different point of view than I might have come into the room with. It's not gonna change my mind about how important women's health is, but there may be some common ground. - There's going to be some, yeah, I agree. I agree, that's about finding that common ground, and then how can we work together towards this common goal? I think it'd be really important for our listeners before I ask you my last two questions. What are these toolkits that you have on your website? - Yeah, so if you go to SWHR.org, and there's sort of a clickdown of programs or health areas of focus that we work in. And you can see our resources. So there's written resources, you know, PDF versions of patient facing toolkits. We have several in the menopause space. We have them in endometriosis. You learn fibroids, migraine. We just had a narcolepsy autoimmune. - Yes, I mean, like, so many. - So many. - We have so many. And then we also do a lot of free webinars. So, you know, those are all archived as well on our website. So definitely worth taking a look. And then we have a policy agenda. So if there's a bone health, for example, or Alzheimer's disease, there's that piece of it. We also have an advocacy toolkit, which although it is, you know, - Oh, it's just what it's going to ask about. - It's free, of course. There's a webinar that goes along with it too. So you can see how, you know, someone might use it or we walk through it a little bit. But that's really, although it is, you know, tailored to US policy, the principles of how you advocate are the same everywhere. And so it'll let you walk through. It will get into the nitty gritty of the US system. But it will also, there's a worksheet at the end of it. So you can kind of write down, here's the thing that I care about. Here's how I want to, you know, phrase this. Here's how I might want to reach out to my policy maker to get people more comfortable with it because, you know, once we start thinking of ourselves as advocates, I think that will also move the needle forward. But everything is there, not, you know, not be kind of paywall, the national strategy that, you know, I've been talking about, also lives over there too. So that's our policy menu option. But yeah, everything is there to look around and available for use. And we'd love for people, of course, to sign up for our newsletter because all of those resources are linked there as well. I'm signed up for the newsletter, and I love it. All right, well, thank you so much. Thanks for taking the time. I really, really appreciate it. What the work that you're doing is so great and amazing. I love this new national strategy, and I'm hoping that Canada can learn from. And I know that you'll be coming to Toronto in November. - I know, I'm excited. - We can talk more about it. I'm excited too. - And maybe I'll have more by then too. I think we'll have a little bit more in terms of the strategy for the strategy. - Yeah, great. - But I'll plan out. But I think for me, really learning from what others are doing so that we can tackle this together is the most important piece. - Yes, I 100% agree with you. And there'll be people, researchers, but also some advocates as well from across Europe and Australia, so the US, of course, as well. So my last two questions to you are fun questions. What gets you up in the morning and what puts you to sleep at night? - Okay. - Different. - Well, I mean, the true answer for what gets me up in the morning is my dog in a cup of coffee. - But-- (laughing) - Wait, do you have an automatic coffee maker that, like, you smell like-- - Oh, yes, oh, yes, I have to. I live a coffee problem. - Oh, my gosh, that's amazing. - I have a coffee problem. But I do think that the work that we do here at the society, I can see this through, like, I could not envision myself working in a different space. It really is very meaningful and the work that we get to do every day, although it's a big challenge, we just know that it has to be done. So that's sort of what gets me up. And it's different every day too, right? Like, I can be talking about autoimmune or maternal health or-- - I have, you did one on-- - I have too, I know, yeah. - Yeah, vision health. Yeah, yeah, we learn so much. So it's fascinating. And we're thankful that you do do it. So thank you very much. - And to put you to sleep-- - Going to bed? - Yeah. - I mean, you know, I think just knowing that you've, you're working toward the right thing, right? And you put the time in and the work in and that can be exhausting as we've talked about, right? - Yes. - We're tired of tiring. - I feel-- - And it will-- - And it will-- - Yeah, right. - It will put you to sleep. But I think just having that level of fulfillment in what it is that we're doing, despite whatever challenges might come our way, is really where we're able to find peace, right? At the end of the day. So we've got to get rest to do it again tomorrow. - Exactly, get up and do it again tomorrow with our coffee. - I mean, have to, I have to. - That sounds great. - Well, thank you so much, Katie, for helping us understand how policy can better serve women's health. - And thank you for listening. If you enjoyed today's conversation, follow the show, leave a rating, and share this episode with someone who cares about women's health, and don't forget to follow us for more conversations, research, and stories. We'll be back soon with another episode of Women's Health Interrupted.